Attention deficit disorder (ADD), is the old name for a disorder in which a person shows a certain pattern of behavior over time. This pattern includes inattention and impulsivity. Attention deficit / hyperactivity disorder, (AD/HD) as it is now called, is characterized by physical hyperactivity, impulsivity, and/or distractibility, in addition to the other behaviors.
In people who have AD/HD, the parts of the brain areas that control attention use less glucose than in other individuals. This indicates that the areas are less active. The lower activity level seems to cause inattention. Researchers are also finding problems in other areas of the brain in people with AD/HD. No one knows for sure why these brain areas are less active.
People who have AD/HD show signs of inattention, including the following: being easily distracted by sights, sounds, and other stimulilosing or forgetting tools and materials needed for a jobmaking careless mistakes because of poor attention to details
Someone who has AD/HD may also show signs of impulsivity and hyperactivity, such as: feeling restless much of the timefidgeting or squirminghaving trouble waiting in lineinterrupting while another person is speakingmoving around when quiet behavior is expected
No one knows the exact cause of AD/HD. Most experts believe that the following factors may play a role in causing AD/HD: environmental toxins, such as leadgeneticssmoking or alcohol use by the mother during pregnancyuse of illegal drugs, such as cocaine, by the mother during pregnancy
AD/HD is thought to affect 5% to 10% of school-age children. Boys are 10 times more likely than girls to be affected by AD/HD.
Many times, AD/HD cannot be prevented. However, these measures may be helpful: avoiding pregnancy risk factors, such as drugs, alcohol, and smokingobtaining good prenatal care beginning in the first trimester of pregnancytaking steps to avoid lead poisoning in the environment
Diagnosis of AD/HD begins with a medical history and physical exam. The healthcare provider will look for behaviors that are typical of AD/HD.
In order to diagnose AD/HD, the provider must determine that the behaviors have the following characteristics: are more frequent or severe than in other people of the same age groupcreate significant disability in at least two of the following areas: school, home, work, or social settingshave continued for at least 6 monthsstarted early in life, before age 7
The healthcare provider may order some of the following tests to rule out other disorders: allergy testsblood and urine testscranial CT scancranial MRI
Without effective treatment, AD/HD can cause serious problems at school, home, work, and in social settings.
AD/HD is not contagious and poses no risk to others. There may be a genetic component to the disorder.
Treatment for AD/HD usually involves medicine along with one or more other strategies. The most common medicine for AD/HD is a stimulant called methylphenidate. This medicine is available in a number of name-brand products, such as Ritalin, Concerta, or Metadate.
Other medicines used to treat AD/HD include the following: amphetamines, such as Adderall, Dexedrine, or Dextrostatantidepressants, such as desipramine (i.e., Nerpramin) or bupropion (i.e., Wellbutrin)medicines normally used to treat high blood pressure, such as clonidine (i.e., Catapres)
Medicines are often used together with other treatment strategies, such as: cognitive behavioral therapyemotional counselingpractical support for activities of daily livingpsychotherapysocial skills training for the individualstress management trainingsupport groups
Side effects from medicine can include the following: headacheinvoluntary muscle movementsloss of appetitemood changes as medicine wears offsleep disordersweight management problems
A person who is receiving any form of therapy may show an initial increase in negative behavior. This may last until new behaviors become routine.
Treatment and monitoring of AD/HD can be lifelong for many patients, although for some, the symptoms seem to reduce or go away over time.
Any new or worsening symptoms should be reported to the healthcare provider.
"Attention-Deficit and Disruptive Behavior Disorders", V Sharma et al, in Psychiatry, A. Tasman et al, eds., 1997, pp. 667-682.
"Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence", CW Popper and RJ Steingard, in Synopsis of Psychiatry, RE Hales and SC Yudofsky, eds., 1996, pp. 681-774.
Diagnostic and Statistical Manual of Mental Disorders, Fourth Ed. American Psychiatric Association Press, 1994.
